Teaching Hygiene Using Executive Functions

Executive Function is defined as a set of processes that address managing oneself and one’s resources to achieve a particular goal. It falls under neurologically-based skills, which consist of mental control and self-regulation. Simply put, executive function is a set of mental skills that help you get things done. For a neurotypical person, this skill set is second nature and doesn’t involve a lot of processing. For people on the autistic spectrum, this skill set is much harder to achieve and involves a lot of thought, processing, and conditioning.

One of our goals at CIP is to help students self-regulate and control functions directly related to hygiene and personal presentation. We help students achieve this through various levels of conditioning, tools, resources, and monitoring over a period of time. Eventually, it will become self-regulating and students will hold themselves responsible to complete the tasks.

Establishing Routines & Processes

In the beginning stages of using executive functioning skills for hygiene, it is very important to establish routines and make many reminders. It is also important to ensure the process is self-regulated and self-reported.

Creating a clear process is very important. This can be accomplished using a step-by-step guide. When beginning, first have the student do a self-evaluation, determine their personal process, and build from there. Ask them what hygiene goals are easy for them and which require more attention. Determine what they are currently doing correctly and also determine areas in which they need to build. After all information has been established, a step-by-step chart should be created with additional reminders and logs. An important factor to keep in mind is that every small detail counts.

Creating Guidelines

There are many different ways and methods for creating the step-by-step charts. Certain methods work better for some, while others require a different approach. Most students do well with a structured chart, consisting of step-by-step directions, ending in a certain result.

For example, let’s look at a step-by-step chart on brushing teeth. Brushing teeth may seem like a simple concept for a neurotypical person but the process is actually quite long when you break it up:

1. Get toothbrush, toothpaste and floss
2. Wet toothbrush
3. Put toothpaste on brush
4. Brush front of teeth
5. Brush back of teeth
6. Brush tongue
7. Spit in sink
8. Wash toothpaste off brush
9. Floss teeth
10. Throw away floss

Now, imagine this being your thought process for all hygiene tasks. It can become complicated and frustrating.   

Other methods include pictures, diagrams, checklists, detailed timer charts, etc. The actual approach is determined by the individual and what works best for their method of processing. Some students require a more in-depth process. For some, an actual demonstration is the most efficient. Once they see the process completed by another person, it makes it easier to replicate. Another successful technique, similar to an actual demonstration, is informational and instructional videos.

Make Sure You Have Goals

Establish key goals in hygiene and build them into a self-regulating check-in system. As previously discussed, young adults on the spectrum have a tendency to complete hygiene tasks for the approval of others (i.e. parents/teachers) without focusing on the actual personal goal.

What is the actual goal and outcome of each individual hygiene skill?

• Brushing teeth
  • Outcome = Clean teeth and fresh breath
• Showering
  • Outcome = Smell good and look presentable
• Wash laundry
  • Outcome = Clothes smell good, look clean and presentable
    
    

And so on. Once they realize these goals, it helps them continue to self-regulate without the reminders or help from the teacher.

Teaching executive functioning skills for hygiene is a complicated process. It is a process that takes time and results are not always immediate. It is a team effort and hard work is required work from the student as well as the teacher. It is important for them to stay focused, driven and determined, while it is equally important for the teacher to guide the way, track the process and hold them accountable. Supporting them throughout the entire process will allow the skill to become natural and a normal part of their daily routine.